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School looks different for every child this year. That's a given, whether your child has significant disabilities or an IEP. Schools have put considerable effort into planning how to safely return to educating students, whether in person, virtually or some combination. That's quite the challenge in and of itself, without taking into consideration the individual needs of students like Teddy.

We've been in discussions with the school district for 1.5 months with more questions than answers on what school might look like for Teddy this year. We all mutually agree that:

1. Teddy will not physically distance. It will require hands-on physical redirection, frequently, to make any effort at distancing.
2. Teddy will not wear a facemask. We are practicing with him to get him to tolerate one for short periods of time, with the goal of being able to wear one appropriately into and out of appointments. The mask still ends up in his mouth, which negates the entire purpose. 
3. Teddy will not be able to integrate with his 2nd grade peers this school year, which is a critical part of his education.
4. Teddy's seizure disorder means that COVID presents a high risk to Teddy. We've taken ambulance rides because of strep throat and spent time in the ICU with Teddy on a ventilator for a perfect storm of other ordinary illnesses. We don't want to see what COVID does to Teddy.
5. Teddy is not a candidate for virtual learning due to his attention span, desire to manipulate technology and overall comprehension.

I didn't expect the school to have all the answers, so we began piecing together the best plan we could for the school year. Although the school district is willing to accommodate Teddy's inability to wear a mask and distance, that means they will also accommodate those needs for the other students in Teddy's classroom. That means he'd be entirely unprotected, which is problematic given #4. We are still working on piecing that plan together, even though school begins tomorrow. 

One of the easiest starting points is to address therapy, as Teddy gets OT, PT and speech through the school district as part of his IEP. Rather than wait for the school district to propose how those services could be done, knowing that virtual was likely the option we'd hear, we are pursuing outpatient therapy services. Teddy has attended through Children's Hospital all summer safely, and we're comfortable with the precautions and measures taken there. The challenge is in obtaining approvals through both his primary and state insurance as typically insurance won't cover outpatient therapy during the school year due to duplicity in services. Right now, OT is authorized through late September, PT is authorized until the end of the calendar year, and speech is pending. The unfortunate part is that authorizations only go for so many sessions and/or through a certain date and then need to be reapproved. That means there's often gaps in services, which doesn't happen in the school setting.

Anticipating that Teddy wouldn't be in the school building, we also reached out to his music therapy location. We had put services on hold through the pandemic thus far, but we went through their safety protocols and Teddy's needs. We feel comfortable with the measures in place and the risk there, so we are resuming music therapy this week as part of Teddy's curriculum. He adores music (and has the best dance moves) and really benefits from the sessions as they address fine motor, gross motor and speech all using music. 

With all the outpatient therapy sessions, the only remaining pieces were actual academics and the minor detail of childcare. For academics, we advocated for homebound school, which I never had contemplated prior to this year. Essentially, homebound education is for children who are too medically fragile to be in the classroom where a teacher comes a couple times a week to the home to provide instruction. This required obtaining a letter of medical necessity from Teddy's doctor. 

The response from the school district is that homebound education is deemed too high risk during the pandemic, so it's not an option. They could do his homebound instruction virtually, which again isn't an option due to #5 above. I know it's out of the control of everyone whom I spoke to, and I understand the reasons it's deemed too risky for the school staff. But it's completely asinine in my opiion that it's too risky for 1 person to come to our home wearing PPE but it's OK for me to send a non-masked, non-distancing Teddy to school with 400 of his closest friends. 

So after an IEP meeting last week Friday, the plan is for Teddy to begin his academic instruction next week. He will attend school for 30 minutes twice a week for 1:1 instruction with a special education teacher. His team did a fantastic job in finding a space that is right inside the entrance of the school, so Teddy will literally walk into the building and right into the room, which will be sanitized prior to his visits. His teacher will wear PPE to protect himself and Teddy. His teacher will also provide us with worksheets, activities, art projects and the like to work on at home when he's not in therapy. 

We're going to focus again on a visual schedule for Teddy, which we attempted earlier this summer until he dismantled it as a toy rather than tool. We will attempt each day to focus at least on one activity for reading, writing his name, matching activities, turn-taking games, colors, numbers and a handful of other things within our play. We've put together a school cart for Teddy that can conveniently be rolled into the bathroom and locked there when he attempts to dismantle and do everything at once. (Our bathroom is the only sacred place on our first floor where we can lock the door to keep Teddy out. We need a larger bathroom.) I'm hopeful that with time and repetition that we'll be able to settle into some routines to work on these skills throughout the days. The fact that we are rotating two childcare providers with us filling in a few gaps will make it tougher from a consistency standpoint but will help with our patience hopefully. (And when our one childcare provider finds full-time employment elsewhere, I will cry. I'll be happy for her, but I'll cry.)

It looks so nice ... until Teddy touches it.

Do I wish Teddy got more than 1 hour of actual instruction a week from the school district? Absolutely, I feel like he deserves more. But I also recognize that if we felt it was safe for him to attend school that he'd likely be attending 5 days a week, possibly even when the rest of the school moves to virtual due to risk. The district understands that children with as significant of needs as Teddy has desperately need that structure and support of daily routines and reinforced learning to not regress, much less learn.

I feel that puts tremendous pressure on us and our amazing, phenomenal childcare providers more than ever to do our best to be occupational therapists, physical therapists, speech therapists, music teachers, art teachers, adaptive gym teachers, special education teachers, chauffeurs and playmates ... while ensuring AJ gets the academic and emotional support he needs. We will make it work, and we'll strive to have grace with each other and ourselves. At least this year should make any future back-to-school season a piece of cake.